Importance. Individuals with chronic stroke experience decreased participation in activities with cognitive demands across all areas of occupation. Objective. To understand the extent to which apathy, cognition, and social support predict participation in activities with cognitive demands. Design. Prospective, quantitative correlational, cross-sectional study. Setting. Outpatient treatment centers and community stroke support groups located in St. Louis, MO, and Boston, MA. Participants. 81 community-dwelling -month poststroke with and without aphasia. Measures. Participants completed the Activity Card Sort (ACS), Apathy Evaluation Scale (AES), Medical Outcomes Study Social Support Survey (MOS-SSS), and Delis-Kaplan Executive Function System (DKEFS) Design Fluency and Trail-Making subtests. Results. Cognitive deficits limit participation in activities with high cognitive demands. Apathy and positive social interaction influence participation, regardless of high or low cognitive demands. Poststroke aphasia did not impact return to participation in activities with high and low cognitive demands. Conclusions and Relevance. Cognitive deficits seen poststroke contribute to participation only for activities with high cognitive demands. Apathy has a significant and negative influence on participation overall. Social support is a modifiable contextual factor that can facilitate participation. Poststroke apathy can be detrimental to participation but is not well recognized. The availability of companionship from others to enjoy time with can facilitate participation.

中文翻译：

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冷漠、认知障碍和社会支持有助于中风后参与认知要求高的活动

重要性。患有慢性中风的个体在所有职业领域中对具有认知需求的活动的参与度降低。客观。了解冷漠、认知和社会支持在多大程度上预测参与有认知需求的活动。设计。前瞻性、定量相关、横断面研究。设置。位于密苏里州圣路易斯和马萨诸塞州波士顿的门诊治疗中心和社区中风支持小组。参与者。81 社区住宅-有和没有失语的中风后一个月。措施。参与者完成了活动卡片分类 (ACS)、冷漠评估量表 (AES)、医学结果研究社会支持调查 (MOS-SSS) 和 Delis-Kaplan 执行功能系统 (DKEFS) 设计流畅性和线索制作子测试。结果。认知缺陷限制了参与具有高认知需求的活动。无论认知需求高低，冷漠和积极的社交互动都会影响参与。卒中后失语症不影响重新参与具有高和低认知需求的活动。结论和相关性. 中风后出现的认知缺陷仅有助于参与具有高认知需求的活动。冷漠对整体参与有显着的负面影响。社会支持是可以促进参与的可改变的背景因素。中风后冷漠可能不利于参与，但并未得到很好的认识。与他人共度时光的陪伴可以促进参与。